Provider Demographics
NPI:1033266721
Name:BATTULA, SIREESHA (DPM)
Entity Type:Individual
Prefix:DR
First Name:SIREESHA
Middle Name:
Last Name:BATTULA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:SIREESHA
Other - Middle Name:
Other - Last Name:BATTULA DUGGIRALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:400 EVELYN AVE STE 223
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1375
Mailing Address - Country:US
Mailing Address - Phone:510-379-7245
Mailing Address - Fax:510-379-5149
Practice Address - Street 1:400 EVELYN AVE STE 223
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1375
Practice Address - Country:US
Practice Address - Phone:510-386-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4701213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BB311ZMedicare PIN
CABB311AMedicare PIN